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This version was machine-translated from German and has not been medically reviewed. The authoritative version is the German version.

Pediatric Appendicitis Score (PAS)

Eight criteria from history, examination, and blood count, 0–10 points, thresholds according to Samuel 2002

Cough, percussion or hopping tenderness in the right lower quadrant

Scored as a single variable in the original (r = 0.9), hence 2 points.

no 0 yes 2

Tenderness in the right lower quadrant (McBurney)

no 0 yes 2

Migration of pain to the right lower quadrant

no 0 yes 1

Anorexia

no 0 yes 1

Nausea or vomiting

no 0 yes 1

Fever

no 0 yes 1

Leukocytosis ≥ 10,000/µl (≥ 10 × 10⁹/l)

no 0 yes 1

Polymorphonuclear neutrophilia (left shift)

no 0 yes 1

Thresholds according to the original publication

Total	Designation according to source
0–5	Score ≤ 5: “not compatible with the diagnosis of appendicitis”
6	Score 6: “compatible with the diagnosis of appendicitis”
7–10	Score 7–10: “high probability of appendicitis”

Samuel 2002, p. 879: “a score of ≤ 5 is not compatible with the diagnosis of appendicitis, whereas a score of ≥ 6 is compatible with the diagnosis of appendicitis. Scores of 7 to 10 indicate high probability of appendicitis.” The author describes the PAS as an aid for repeated structured examination, to be compared with the clinical impression; if the diagnosis is unclear, re-evaluate after 4 hours.

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Sources

Pediatric Appendicitis Score (J Pediatr Surg 37:877–881) – Table 2, section PAS, addendum Samuel M, Great Ormond Street Hospital for Children, London, 2002. Original study (1,170 children aged 4 to 15 years; freely available via the University of Florida, full text read)

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Note

Calculation aid for healthcare professionals. Clinical assessment remains with the treating physician.

Review date of the German original: 2026-11-05 · Methodology

Frequently asked questions

Pediatric Appendicitis Score (PAS): What does this calculator compute?

Pediatric Appendicitis Score (PAS) after Samuel 2002: click eight criteria, sum 0–10 and the thresholds of the original paper (≤ 5, ≥ 6, 7–10), with documentation text.

Pediatric Appendicitis Score (PAS): Which sources is this calculator based on?

Kelly CS, Andersen CL, Pestian JP, et al.: Improved outcomes for hospitalized asthmatic children using a clinical pathway (Ann Allergy Asthma Immunol 84:509–516) (2000); Qureshi F, Pestian J, Davis P, Zaritsky A: Effect of nebulized ipratropium on the hospitalization rates of children with asthma (N Engl J Med 339:1030–1035) (1998)